Swinging Sixties blamed for cancer
By CELIA HALL
Sunday 25 February 2001
A sharp rise in rates of pre-cancer of the cervix among young women is
probably the result of increased sexual activity since the 1960s, according
to new research.
The effect of the contraceptive pill and the lessening of the stigma
attached to pregnancy before marriage have contributed to a threefold
increase over 10 years, according to Amanda Herbert, who conducted the
research. Untreated, the suspect cells develop into cancer in one in three
Dr Herbert, a consultant cytopathologist at St Thomas' Hospital, London,
said the increase had been masked by a national cervical screening program
which had reduced cases of cancer and deaths.
Human papilloma virus is the main cause of cervical cancer and is spread by
sexual intercourse. Dr Herbert found more than 19,000 cases in 1991
compared with 5924 in 1981 and 2211 in 1971.
Screening was available in the 1970s in Britain but was not organised
nationally. Dr Herbert said some of the increase could be accounted for by
the greater numbers of young women screened by 1991, but not all of it.
In the 1991 group, cases peaked among women aged between 25 and 30. In 1981
the peak was among women four or five years older.
Dr Herbert said that if the pre-cancer cases had not been picked up by
screening and treated, cases of cancer of the cervix could have been
expected to have doubled in older women.
"These findings tell us that just because cervical cancer is now much less
common we must not become complacent. It is crucial that women have regular
tests and do not miss the opportunity to reduce that risk," she said.
"We have known for a long time that cervical cancer is associated with
sexual activity. We saw an increase after the First and Second World Wars
when there was greater opportunity for men and women to get around.
"Then there was the sexual revolution of the 1970s. I am not saying that it
is caused by wild promiscuity. One extra partner increases the risk."
The study, in the journal Cytopathology, said that the cost of national
screening had recently been questioned but it was important that young
women continued to be screened.
There was some indication that the high number of pre-cancers of the cervix
in young women was starting to fall, possibly because of a greater use of
condoms for fear of AIDS, Dr Herbert said in the report.
Anne Szarewski, of the Imperial Cancer Research Fund, said: "Without
screening we would probably be seeing an epidemic. We estimate that by 2025
screening could prevent 5000 cancers a year."
The incidence of cervical cancer fell 42 per cent between 1988 and 1997.
It now causes 1100 deaths a year in England and Wales.
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